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Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease

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Abstract

Background

Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease.

Objective

To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease.

Materials and methods

Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle.

Results

Patients and controls (age: 8 years—20 years) were matched for age, height, weight, gender and heart rate. Patients had higher systolic blood pressure. No patient had left ventricular hypertrophy on MRI or diastolic dysfunction on echocardiography. Fifteen patients underwent tissue Doppler echocardiography, with normal z-scores for mitral early diastolic (VE), late diastolic (VA) and peak systolic (VS) velocities. Throughout all left ventricular levels, peak diastolic Vz and Vr (cm/s) were reduced in patients: Vzbase -10.6 ± 1.9 vs. -13.4 ± 2.0 (P < 0.0003), Vzmid -7.8 ± 1.6 vs. -11 ± 1.5 (P < 0.0001), Vzapex -3.8 ± 1.6 vs. -5.3 ± 1.6 (P = 0.01), Vrbase -4.2 ± 0.8 vs. -4.9 ± 0.7 (P = 0.01), Vrmid -4.7 ± 0.7 vs. -5.4 ± 0.7 (P = 0.01), Vrapex -4.7 ± 1.4 vs. -5.6 ± 1.1 (P = 0.05).

Conclusion

Tissue phase mapping is feasible in children and adolescents. Children with chronic kidney disease show significantly reduced peak diastolic long- and short-axis left ventricular wall velocities, reflecting impaired early diastolic filling. Thus, tissue phase mapping detects chronic kidney disease-related functional myocardial changes before overt left ventricular hypertrophy or echocardiographic diastolic dysfunction occurs.

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Acknowledgments

We thank Adriana Komancsek (radiographer) and her team for the competent acquisition of cardiac MR images.

Author information

Authors and Affiliations

  1. Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center - University of Freiburg, Mathildenstr. 1, 79106,, Freiburg, Germany

    Charlotte Gimpel & Martin Pohl

  2. Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern, Bern, Switzerland

    Bernd A. Jung

  3. Department of Nuclear Medicine, Medical Center - University of Freiburg, Freiburg, Germany

    Sabine Jung

  4. Department of Cardiology and Angiology I, University Heart Center Freiburg, Freiburg, Germany

    Johannes Brado & Katja E. Odening

  5. University Children’s Hospital Zurich, Zurich, Switzerland

    Daniel Schwendinger

  6. Pediatric Heart Center, University Children’s Hospital Zurich, Zurich, Switzerland

    Barbara Burkhardt

  7. Department of Radiology, University Children’s Hospital Zurich, Zurich, Switzerland

    Julia Geiger

  8. Department of Radiology, Northwestern University, 737 N. Michigan Ave., Chicago, IL, USA

    Julia Geiger

  9. Department of Pediatric and Congenital Cardiology, University Hospital Heidelberg, Heidelberg, Germany

    Raoul Arnold

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  1. Charlotte Gimpel
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Correspondence to Charlotte Gimpel.

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Gimpel, C., Jung, B.A., Jung, S. et al. Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease. Pediatr Radiol 47, 169–177 (2017). https://doi.org/10.1007/s00247-016-3741-5

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  • DOI: https://doi.org/10.1007/s00247-016-3741-5

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